Goals of Asthma Treatment
The medications used for asthma treatment are often described as “preventers” and “relievers.” If your doctor prescribed preventive medicine for you to take every day it is because your asthma symptoms happen too often. You MUST take it every day to stay well. Daily medicines won’t prevent every asthma attack but if you use them every day, you won’t get sick as often and you will be able to exercise without asthma problems most of the time. The most common “preventer” medicines are inhaled steroids that can be inhaled from a metered dose inhaler or from a dry powder inhaler.
If you or your child develop asthma symptoms of cough, wheeze and/or shortness of breath, the treatment to add is a “reliever” medicine. These are most often metered dose inhalers that provide quick relief from symptoms. They may be repeated as often as every four hours as needed. If the reliever medicine does not provide relief, that relief does not last at least 4 hours or you have needed to use the inhaler repeatedly during the day, it is time to call your doctor for advice about the next level of treatment.
Oral steroids like prednisone are sometimes used when preventers and reliever medications are not helping with asthma symptoms. This medicine is usually prescribed twice daily for 5 days to reduce the airway swelling, or inflammation, from an asthma episode. Steroids taken by mouth can have serious side effects if used too much. It is important to use them only if directed by your physician.
Using Inhaled Medications
Most asthma medicines are provided in forms that are breathed into the lungs providing treatment directly to the airways. This is very effective and these medications have very few side effects. They work very well if the child learns to take them correctly. You should expect your doctor’s office to teach you and your child how to use the medicine prescribed.
Metered Dose Inhaler
A metered dose inhaler (MDI) is one way of delivering medicine directly into the lungs. When medicine is swallowed you must wait for your body to absorb it, and for the blood to carry it to the lungs. With inhaled medicine, the medicine is breathed in directly to the lung tissue. This makes the medicine work faster, better, and with fewer side effects. The canister of the MDI holds the medicine under pressure. Triggering the MDI releases the medication which is drawn into your lungs with a breath. Coordinating the release of the medication and the intake of air is the hardest part of using a MDI. Many kinds of medications are given in MDI’s. It is important for you to know the name and purpose of the medications your child is on. You should know whether the medicine is for immediate treatment or prevention and how often to use it. If you give the wrong medication for acute symptoms, your child may get much sicker than necessary. If you fail to give preventive medications regularly, your child may be sick more often.
For children who are too young (usually ages 4-8 years) to coordinate triggering the inhaler as they breathe in, chambers such as the Aero-Chamber, Opti-Chamber or Vortex are used. Once assembled, the medication is put into the chamber. Use 1 puff and complete the following sequence twice: Your child simply places his/her mouth over the mouthpiece and breathes in slowly and deeply, sucking the medication into his/her lungs. Have your child hold his/her breath about 10 seconds, breathe out normally, then repeat the deep breath in and hold again. Wait 2-3 minutes and repeat this process, until the prescribed number of puffs are taken The child should either wear a nose clip or hold the nose closed when inhaling through the chamber to be sure he/she is only breathing through the mouth.
Dry Powder Inhalers
Many inhaled asthma medications are now delivered by a dry powder inhaler or DPI. The design of the device is different for each medication. It is important to ask your doctor or practitioner to teach your child correct use of the medication prescribed.